Comparison of the performance of currently used estimated glomerular filtration rate equations with 24-hour urine creatinine clearance: sample analysis of randomised controlled trial participants
Objective There are several equations for estimating the glomerular filtration rate (GFR), and each method has its limitations. We compared various estimated GFR (eGFR) equations with 24 hours urine creatinine clearance (24u-CCr).Design Sample analysis of randomised controlled trial participants.Set...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/8/e067398.full |
| _version_ | 1797738302917312512 |
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| author | Sohee Oh Jin Ho Hwang Chun Soo Lim Dong Ki Kim Suhnggwon Kim Sang-Ho Lee Jung Hwan Park Ho Jun Chin Sejoong Kim Sung Joon Shin Bum Soon Choi |
| author_facet | Sohee Oh Jin Ho Hwang Chun Soo Lim Dong Ki Kim Suhnggwon Kim Sang-Ho Lee Jung Hwan Park Ho Jun Chin Sejoong Kim Sung Joon Shin Bum Soon Choi |
| author_sort | Sohee Oh |
| collection | DOAJ |
| description | Objective There are several equations for estimating the glomerular filtration rate (GFR), and each method has its limitations. We compared various estimated GFR (eGFR) equations with 24 hours urine creatinine clearance (24u-CCr).Design Sample analysis of randomised controlled trial participants.Setting and participants We compared the mean 24u-CCr values measured 2–3 times for 211 patients with eGFR values calculated using the following equations: isotope dilution mass spectrometry-Modification of Diet in Renal Disease (IDMS-MDRD) equation, Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation, equations for Koreans (KOR-IDMS-MDRD and KOR-CKD-EPI) and full age spectrum equation.Outcome measures Performance of various creatinine-based eGFR equations, including those with Korean coefficients, compared with the results of the 24u-CCr.Results IDMS-MDRD showed the best overall correlation with the 24u-CCr (R=0.949, p<0.001), and KOR-CKD-EPI showed the best agreement in terms of the intraclass correlation coefficient (ICC, 0.969, 95% CI 0.959 to 0.976, p<0.001). In subgroup analysis, IDMS-MDRD-GFR showed the highest ICCs in CKD stages 1 and 3 (ICC 0.872 in stage 1 and 0.927 in CKD stage 3, all p<0.001). KOR-CKD-EPI showed the highest ICC in CKD stage 2 (ICC 0.854, p<0.001). Overall, the accuracy of CKD-EPI (2021) was the highest at P15 (15%) and P30 (30%) (P15: 65.4 and P30: 97.6). In addition, CKD-EPI (2021) showed the highest P30 accuracy in CKD stage 1 (98.7), whereas KOR-IDMS-MDRD showed the highest P30 accuracy in CKD stages 2 and 3 (98.8 and 98.2, respectively).Conclusions The IDMS-MDRD equation showed the best correlation and overall good agreement with the 24u-CCr; however, the accuracy was low. The most accurate measurements were obtained using the CKD-EPI (2021) equation in CKD stage 1 and the KOR-IDMS-MDRD equation in CKD stages 2–3; nevertheless, the CKD-EPI (2021) equation showed the best overall accuracy.Trial registration number NCT01552954. |
| first_indexed | 2024-03-12T13:40:53Z |
| format | Article |
| id | doaj.art-1b825573d4f748698b9f704151872d5a |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T13:40:53Z |
| publishDate | 2023-08-01 |
| publisher | BMJ Publishing Group |
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| spelling | doaj.art-1b825573d4f748698b9f704151872d5a2023-08-23T16:20:07ZengBMJ Publishing GroupBMJ Open2044-60552023-08-0113810.1136/bmjopen-2022-067398Comparison of the performance of currently used estimated glomerular filtration rate equations with 24-hour urine creatinine clearance: sample analysis of randomised controlled trial participantsSohee Oh0Jin Ho Hwang1Chun Soo Lim2Dong Ki Kim3Suhnggwon Kim4Sang-Ho Lee5Jung Hwan Park6Ho Jun Chin7Sejoong Kim8Sung Joon Shin9Bum Soon Choi106Department of Biostatistics, Seoul National University Boramae Hospital, Seoul, KoreaDepartment of Internal Medicine, Chung-Ang University College of Medicine and Graduate School of Medicine, Seoul, Korea (the Republic of)Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of)Kidney Research Institute, Seoul National University, Seoul, Korea (the Republic of)3 Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of KoreaDepartment of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea2Dankook University Hospital, Cheoan, South KoreaDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea (the Republic of)Department of Internal Medicine, Seoul Saint Mary`s Hospital, Seoul, Korea (the Republic of)Objective There are several equations for estimating the glomerular filtration rate (GFR), and each method has its limitations. We compared various estimated GFR (eGFR) equations with 24 hours urine creatinine clearance (24u-CCr).Design Sample analysis of randomised controlled trial participants.Setting and participants We compared the mean 24u-CCr values measured 2–3 times for 211 patients with eGFR values calculated using the following equations: isotope dilution mass spectrometry-Modification of Diet in Renal Disease (IDMS-MDRD) equation, Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation, equations for Koreans (KOR-IDMS-MDRD and KOR-CKD-EPI) and full age spectrum equation.Outcome measures Performance of various creatinine-based eGFR equations, including those with Korean coefficients, compared with the results of the 24u-CCr.Results IDMS-MDRD showed the best overall correlation with the 24u-CCr (R=0.949, p<0.001), and KOR-CKD-EPI showed the best agreement in terms of the intraclass correlation coefficient (ICC, 0.969, 95% CI 0.959 to 0.976, p<0.001). In subgroup analysis, IDMS-MDRD-GFR showed the highest ICCs in CKD stages 1 and 3 (ICC 0.872 in stage 1 and 0.927 in CKD stage 3, all p<0.001). KOR-CKD-EPI showed the highest ICC in CKD stage 2 (ICC 0.854, p<0.001). Overall, the accuracy of CKD-EPI (2021) was the highest at P15 (15%) and P30 (30%) (P15: 65.4 and P30: 97.6). In addition, CKD-EPI (2021) showed the highest P30 accuracy in CKD stage 1 (98.7), whereas KOR-IDMS-MDRD showed the highest P30 accuracy in CKD stages 2 and 3 (98.8 and 98.2, respectively).Conclusions The IDMS-MDRD equation showed the best correlation and overall good agreement with the 24u-CCr; however, the accuracy was low. The most accurate measurements were obtained using the CKD-EPI (2021) equation in CKD stage 1 and the KOR-IDMS-MDRD equation in CKD stages 2–3; nevertheless, the CKD-EPI (2021) equation showed the best overall accuracy.Trial registration number NCT01552954.https://bmjopen.bmj.com/content/13/8/e067398.full |
| spellingShingle | Sohee Oh Jin Ho Hwang Chun Soo Lim Dong Ki Kim Suhnggwon Kim Sang-Ho Lee Jung Hwan Park Ho Jun Chin Sejoong Kim Sung Joon Shin Bum Soon Choi Comparison of the performance of currently used estimated glomerular filtration rate equations with 24-hour urine creatinine clearance: sample analysis of randomised controlled trial participants BMJ Open |
| title | Comparison of the performance of currently used estimated glomerular filtration rate equations with 24-hour urine creatinine clearance: sample analysis of randomised controlled trial participants |
| title_full | Comparison of the performance of currently used estimated glomerular filtration rate equations with 24-hour urine creatinine clearance: sample analysis of randomised controlled trial participants |
| title_fullStr | Comparison of the performance of currently used estimated glomerular filtration rate equations with 24-hour urine creatinine clearance: sample analysis of randomised controlled trial participants |
| title_full_unstemmed | Comparison of the performance of currently used estimated glomerular filtration rate equations with 24-hour urine creatinine clearance: sample analysis of randomised controlled trial participants |
| title_short | Comparison of the performance of currently used estimated glomerular filtration rate equations with 24-hour urine creatinine clearance: sample analysis of randomised controlled trial participants |
| title_sort | comparison of the performance of currently used estimated glomerular filtration rate equations with 24 hour urine creatinine clearance sample analysis of randomised controlled trial participants |
| url | https://bmjopen.bmj.com/content/13/8/e067398.full |
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